(New Orleans) Ask almost anyone about cancer and they’ll probably list lung, breast and prostate as major killers. But the one they won’t list is colorectal cancer, even though it is the second-leading cause of cancer death in both Louisiana and the United States.

That is why the Louisiana Comprehensive Cancer Control Program (LCCCP) is encouraging all Louisianians 50 and over, to talk to their doctors about getting screening during March Colorectal Cancer Awareness Month. This discussion is especially important for African American men and Cajuns, as they suffer disproportionately from the disease. African American men face a number of barriers when it comes to colorectal cancer screening, including a lack of access to screening and/or a doctor recommendation, as well as avoidance of the issue. And the recent Tulane/LSU study showing that Cajuns have a higher incidence of the disease, points to genetic factors as the culprit.

Either way, everyone 50 and over needs to get a colorectal cancer screening on a regular basis. That is because colorectal cancer is a preventable disease and people are often dying from it because of misconceptions and myths. 

Colorectal Cancer Risk Factors

For example, according to research from the National Colorectal Cancer Roundtable (NCCRT), most people know they should be screened. But they do not recognize the importance of screening and rationalize away the need for it. In addition, people believe that because they have no symptoms or family history of the disease, or that because they don’t know anyone personally with cancer, they can’t get it. There are  people who believe they are healthier than they really are, even though they don’t practice good health habits in general or discuss things with their doctor – or even go to the doctor. LCCCP Manager Colleen Huard also notes that women often mistakenly believe they can’t get colon cancer, which is not true, as women get it at the same rates as men.

Perhaps most insidious of all the beliefs that the NCCRT turned up is the negative connotation that some people associate with colorectal cancer screening, believing it to be an embarrassing, unpleasant or invasive process. That phenomena is often referred to health experts as “letting yourself die from embarrassment” and stress that while no one may love getting a colonoscopy or doing an at-home stool test, these are standard tests with minimal risk that can prevent much more serious and invasive consequences down the road.

Two other sad factors also keep people from getting screened. One is a lack of affordability, which is the number one reason people don’t get screened. Fortunately, under the Affordable Care Act, preventive screenings such as colonoscopies are now covered, so more people than ever before can get screened.

And a top reason that African Americans and Hispanics, two groups who are less likely to get screened, don’t do so is because their doctors aren’t recommending it. That is a behavior that doctors need to change, while patients also need to learn that they need to ask about screenings.

Risk factors for colorectal cancer beyond age, racial/ethnic background and misconceptions, include a history of other diseases, such as Type 2 diabetes; a personal or family history of polyps and/or colorectal cancer; inflammatory bowel disease; and inherited syndromes (FAP, HNPCC, Turcot Sydrome, Peutz-Jeghers Syndrome, MUTYH-Associated Polyposis).

Controllable or lifestyle risk factors that can lead to colorectal cancer include a diet high in red and processed meats, such as beef, pork, lamb, liver, hot dogs and certain kinds of luncheon meats; physical inactivity; being obese; smoking; and heavy use of alcohol (more than two drinks a day for men; one for women.)

Colorectal cancer in Louisiana

Colorectal cancer is such an issue in Louisiana that health experts around the state have come together to form a Louisiana Colorectal Cancer Roundtable (LCCRT). It is modeled after the NCCRT and its goal, like the NCCRT’s, is “80% by 2018” or getting everyone 50 and over screened by that date.

One message the LCCRT will relay is “the best test is the one you’re going to get,” a reference to the fact that there are colorectal cancer screening tests other than colonoscopies that can take place in the hospital, as well as at home. That is why people should discuss their screening options with doctors to be better informed as to what the best is for them, what will be covered by insurance, etc.

To learn more about colorectal cancer, go to http://lcccp.org/colorectal/.

The Louisiana Comprehensive Cancer Control Program (LCCCP) is part of the CDC-funded Louisiana Cancer Prevention and Control Programs (LCP) housed at the LSU Health Sciences Center School of Public Health. For more information, go to www.louisianacancer.org.

AuthorTruc Le

March is Colorectal Cancer Awareness Month, which is a good time to let people know about some research from the National Colorectal Cancer Roundtable (NCCRT). It shows people 50 and over know they should get screened for colorectal cancer, yet it also shows they are letting bad reasons stand in the way of actually doing so.

The NCCRT, which was established by the American Cancer Society and the Centers for Disease Control and Prevention to reduce colorectal cancer incidence and mortality, has categorized people who are not getting screened as:“Procrastinator/ Rationalizers,” “Newly Insured,” and “Financially Challenged,” with the problem being magnified among African Americans and Hispanics who fall in those groups. Characteristics include:

1)    Rationalized Avoidance. People know they should get screened, but don’t acknowledge its importance and rationalize why they don’t need it. Call it the “could-have, should-have, would-have” group.

2)    Lack of Affordability. Not surprisingly, it’s the number one reason people don’t get screened. More surprising is the fact that people don’t seem to know that under the Affordable Care Act, preventive screenings, such as colonscopies, are covered by insurance.

3)    No Symptoms or Family History. Do you really want to wait until you are bleeding from your behind to find out you have colorectal cancer? Symptoms often mean a more advanced stage of the disease. And not having a family history of the disease does not confer magical protection against colorectal cancer.

4)    Negative Connotation. People often think of colorectal cancer screening as invasive, unpleasant or embarrassing. That’s how many women used to think of breast cancer screening too, and, guess what? They also died at much higher rates. It’s time for people to stop “dying from embarrassment” and realize that getting cancer is a lot more invasive and unpleasant than any kind of screening.

5)    No Doctor Recommendation. Doctors need to step up to the plate. African Americans cite the lack of a screening recommendation as the number one reason they do not get them, while Hispanics rank it as the number three reason. That said, people also need to speak up for themselves and talk to their doctors about colorectal cancer screenings.

6)    No Personal Connection. It seems people who have not had a close friend or family member with cancer, or are unaware of their family histories of cancer, tend to think they can’t get it. People are wrong.

7)    Low Levels of Healthy Behavior. Interestingly, there are people who identify themselves as healthy, but don’t live that way, go to the doctor or talk to their doctor about screenings. You can’t just talk the talk – you have to walk the walk.

Colorectal cancer also has risk factors that increase chances for getting the disease, some of which can be controlled and others that can’t. Controllable factors are:

8)    Red and Processed Meats. Sorry, folks, but if your diet includes a lot beef, pork, lamb, liver, hot dogs and certain kinds of luncheon meats, you’re upping your chances for getting colorectal cancer (and a number of other ailments). Cooking meat at very high temperatures may also increase risk.

9)    Physical Activity. Exercise is good for almost anything that ails us.

10) Obesity. If you’re obese, your risk goes up – especially if you’re a man.

11) Smoking. Everyone knows it causes lung cancer. It’s linked to colorectal cancer too, as well as a list of diseases too numerous to list.

12) Alcohol. Keep use moderate. Men should have no more than two drinks a day; women no more than one, to be healthy overall.

And then there are the factors you can’t control:

13)  Age. That is why you start getting regular colorectal cancer screenings at 50.

14)  Racial/Ethnic Background. African Americans have the highest colorectal cancer incidence and mortality rates in the United States. According to The Louisiana Comprehensive Cancer Control Program, recent research is showing that the Cajuns of south Louisiana also have some of the highest incidence rates in the country – probably due to genetic factors.

15)  Other Diseases. If you have Type 2 Diabetesa Personal/Family History of Polyps, Colorectal Cancer; Inflammatory Bowel Disease; or Inherited Syndromes(FAP, HNPCC, Turcot Sydrome, Peutz-Jeghers Syndrome, MUTYH-Associated Polyposis), you have a higher risk of colorectal cancer.  

Colorectal cancer is the second leading cause of cancer deaths in the United States, when you look at men and women combined, with people having a 1 in 20 risk of developing the disease at some point. There is no reason for these deaths as colorectal cancer is preventable, thanks to screenings. What’s more, people have a choice among a number of screening types, ranging from in-hospital procedures to take-home tests. That is why everyone needs to talk to their doctor and decide what is best for them. Remember “the best test is the one you’re going to get.” 

AuthorTruc Le